Clinic
Port Gamble S'klallam Dental Clinic
Port Gamble S'klallam Dental Clinic was paid $3.13M by Medicaid between Jan 2018 and Dec 2024, across 15 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 95% of everything it billed.
33Billing provider infoPORT GAMBLE S'KLALLAM DENTAL CLINIC
KINGSTON, WA 98346
KINGSTON, WA 98346
33aNPI1669531067assigned 12/08/2006
33bProvider typeDental Clinic/Center
28Total paid$3.13M
24GClaims15,361
24DCodes billed15
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Washington
Rank by total paid#32 of 143
Median peer was paid$573K
This provider vs. median5.5×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 2,687 | $418K | |
| 2019 | 3,237 | $473K | |
| 2020 | 1,052 | $210K | |
| 2021 | 1,689 | $328K | |
| 2022 | 2,130 | $563K | |
| 2023 | 2,296 | $580K | |
| 2024incomplete | 2,270 | $558K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 95% | 7,411 | 6,447 | $2.97M |
| D0140 | Limited oral evaluation - problem focused | 1.1% | 1,650 | 1,598 | $34K |
| D1206 | Topical application of fluoride varnish | 1.1% | 2,364 | 2,258 | $34K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | <1% | 1,079 | 1,040 | $25K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 298 | 197 | $19K |
| D0274 | Bitewings - four radiographic images | <1% | 821 | 800 | $10K |
| D0330 | Panoramic radiographic image | <1% | 342 | 335 | $9K |
| D1120 | Dental cleaning, childProphylaxis - child | <1% | 482 | 449 | $9K |
| D1110 | Prophylaxis - adult | <1% | 249 | 246 | $9K |
| D1351 | Sealant - per tooth | <1% | 447 | 99 | $3K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 44 | 44 | $1K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 21 | 13 | $1K |
3 more codes
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialPOWELL, KERSTIN (HEALTH CENTER BUSINESS OFFICE MANAG)
| Provider | Location | Paid |
|---|---|---|
| Port Gamble S'klallam Chemical Dependency Program | Kingston, WA | $3.24M |
| Port Gamble S'klallam Mental Health | Kingston, WA | $1.85M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.